FAQ: Does Alcohol Help or Hurt Your Sleep?
Alcohol is deeply embedded in social and cultural routines, and many people use alcohol to “unwind,” including to help fall asleep. But decades of sleep and neuroscience research show that alcohol consistently disrupts sleep quality, even when it might make people feel sleepy initially. Let’s answer the most common questions about alcohol and sleep, with sleep science.
How common is alcohol use?
Alcohol use is common, but less than most people think. A recent 2025 Gallup Poll showed that just over half of American adults (54%) report drinking alcohol. This is an all-time low for the 90-year survey, down from the mid-60’s for most of that time. Among those who drink, 40% said their last drink was a week or more ago, and 24% had a drink in the past 24 hours. Doing the math, we can extrapolate that a third of American adults drink more than once per week (60% of 54%).
Younger people (Gen Z and later millennials) drink less than older people: 50% of those aged 18-34 reported drinking, versus 56% of people over 35. This is a reversal of prior trends, where regular drinking used to be highest in younger adults, based on CDC data.
Globally, the WHO estimates that 7% of the world population has alcohol use disorder, and alcohol contributed 2.6 million deaths per year (back in 2019).
Obviously, there is a difference between drinking a couple times per week and having alcohol use disorder or dependence (aka “being an alcoholic” in older parlance). But the difference is a slope, not a boundary. Because we sleep every night, using alcohol as a sedative to fall asleep makes the slope to harmful drinking very slippery.
From a sleep perspective, the most relevant drinking patterns are:
Drinking in the evening or close to bedtime
Consuming multiple drinks in a short window
Using alcohol as a sleep aid
Drinking regularly (more days than not)
These patterns are strongly associated with sleep disruption, even when overall weekly intake seems moderate.
Does alcohol help you fall asleep?
Yes, but briefly.
Alcohol has acute sedative effects that initially reduce sleep onset latency, meaning people tend to fall asleep faster after drinking. But people very rapidly develop tolerance to sedative effects of alcohol, meaning higher and higher doses are needed for the same effect. So people who drink regularly do not fall asleep any faster than if they did not drink at all. (For an excellent review, Roehrs & Roth 2001.)
The initial sedative effect is followed by rebound arousal as alcohol is metabolized. Classic polysomnography studies show that alcohol’s sleep-promoting effects wear off within a few hours, setting the stage for the dreaded 3AM awakenings. And at this point in the night, because “sleep drive” has been used up, it is really hard to fall back asleep.
How does alcohol affect sleep stages?
Alcohol reliably alters sleep architecture, based on multiple laboratory studies. One particularly relevant study used gold-standard polysomnography in adults who drank regularly, but did not have alcohol use disorder, to see how alcohol affects sleep stages. (McCullar et al 2024)
Early night, when blood alcohol levels are high:
Suppressed REM sleep
Increased slow-wave sleep
Shorter time to sleep (*not in frequent drinkers - Brower 2001)
Second half of the night, as alcohol is cleared:
Increased awakenings
REM rebound - but in total over the night the amount of REM is still reduced
Lighter, less stable sleep, with less slow-wave sleep
Reduced sleep efficiency
Over the course of the night:
there is less REM sleep, which is important for memory consolidation and mood regulation.
Total sleep time is either unchanged or reduced
Overall sleep is less restorative, which explains why people often wake feeling unrefreshed even if they aren’t necessarily “hung over.”
Why do you wake up at 3 AM after drinking?
Waking up in the early morning after drinking is so, so common, that drinking is the #1 thing I ask patients about if they tell me they wake up in the middle of the night. Alcohol causes middle-of-the-night awakenings by a variety of mechanisms:
Alcohol increases activity in the sympathetic nervous system, so as the sedative effect wears off, people wake up in “fight or flight” mode, aka “hangxiety.
Alcohol increases body temperature, increasing night sweats that can wake people up, especially (peri)-menopausal women who have hot flashes already.
Alcohol is a diuretic so people wake because they have to urinate more.
Relatedly, dehydration may wake people because they are thirsty.
Alcohol relaxes the upper airway muscles, worsening snoring and sleep apnea. Once the sedative effect has worn off, the apneas (stopping breathing) can wake people up
Sleep apnea is worst during REM sleep. Because of the REM rebound in the second half of the night after alcohol, there may be more apneas that wake people up.
Restless legs syndrome (and related, periodic limb movements of sleep) are worsened by alcohol.
In people with REM sleep behavior disorder, alcohol use can trigger episodes.
Alcohol worsens gastric reflux, so people may wake with heartburn.
As alcohol is metabolized, blood sugar levels increase, which can also cause awakenings.
Alcohol suppresses melatonin release and increases cortisol levels, disrupting the circadian clock mechanisms that help keep you asleep in the second part of the night.
These mechanisms explain why alcohol-related insomnia often presents as middle-of-the-night awakenings, not difficulty falling asleep.
What happens to sleep with chronic drinking?
With chronic alcohol use, sleep disruption becomes entrenched.
People with alcohol use disorder frequently experience:
Chronic insommnia: they have a physical dependence to alcohol for the sedative effects, so they have a lot of trouble falling asleep without alcohol, but the same dose doesn’t really help like before
Reduced slow-wave sleep
Reduced REM sleep
Shortened total sleep time
Under-treated or untreated sleep apnea
Dysregulation of the circadian clock
If someone who drinks regularly stops drinking, their sleep does improve, but it takes time. Circadian disruptions take about a month to resolve (Meyrel 2020), and the sleep disturbances and alterations in sleep architecture can persist for months or years. (Brower 2001)
Persistent sleep problems may increase relapse risk, so people with insomnia trying to quit drinking should seek medical attention for sleep problems to maximize their chance of maintaining sobriety.
Can alcohol affect brain health through sleep?
Yes. Chronic alcohol use combined with long-term sleep disruption is associated with:
Impaired attention and executive function
Mood and anxiety disorders
Dementia and cognitive vulnerability with aging
The link between alcohol and dementia has multiple potential pathways, including sleep disruption, inflammation, impaired glymphatic clearance, untreated sleep apnea, circadian disruption, and increased cardiovascular and cerebrovascular strain. Alcohol is itself a potent neurotoxin, ie alcohol kills brain cells.
While dose thresholds remain under investigation, the assumption that “moderate” drinking is neurologically benign is questionable at best.
Bottom line: Is alcohol worth it for sleep?
Absolutely not.
Alcohol may initially help you fall asleep faster, but it consistently worsens sleep quality, causes early morning awakenings, worsens sleep disorders, fragments the night, and reduces restorative sleep stages.
Over time, the effects compound, impacting mood, cognition, and long-term brain health. Also, because we sleep every night, using alcohol as a sleep aid is a shortcut to developing alcohol dependence and alcohol use disorder.
How much alcohol is “safe” for sleep?
There is no amount of alcohol that improves sleep quality.
However, alcohol-related sleep disruption is:
Dose-dependent (more alcohol = worse sleep)
Timing-dependent (closer to bedtime = greater disruption)
There is no “safe” amount of alcohol, just like there’s no “safe” number of cigarettes. Even one or two drinks have documented negative effects on sleep and increase awakenings, particularly in sensitive individuals.
What are tips to drink without wrecking your sleep?
If you choose to drink alcohol, here are some tips to reduce the bad effects on sleep and risks of alcohol abuse:
Finish drinking at least 3–4 hours before bedtime
Limit quantity. Depending on your individual sensitivity, this may be less than one drink.
Choose low- or no-alcohol beverages. Zero-proof or non-alcoholic beverages are the fastest-growing segment of the drinks industry so there are a lot of choices.
Alternate alcohol with water (or no-alcohol drinks) to reduce dehydration and awakenings
Don’t binge-drink (more than 3 drinks)
Schedule regular alcohol-free days. Alcohol-free days should greatly outnumber alcohol+ days.
Don’t use alcohol to “treat” insomnia, anxiety, or stress, as this is liable to become a habit that’s tough to break.
How can I cut back on drinking?
If you’re thinking about cutting back on drinking, here are some tips to cut back alcohol, through the sleep lens.
Dry January, Sober October, and other pre-set periods of abstinence from alcohol do help, including with sleep. In fact, the sleep and circadian benefits might not become apparent until after a few weeks, so hang in there for the full month+! Even light drinkers are often pleasantly surprised at how much sleep, mood, and energy improve after a month or more of no alcohol.
Wearables: If you are motivated by data, you can compare your sleep quality, resting heart rate, or heart rate variability on nights with and without drinking. Better yet, try whole month increments.
Don’t drink at home. Not having it accessible at home makes it less likely you will drink, especially close to bedtime.
Spend time with people who don’t drink, especially in the evening. Remember, the majority of adults do not drink regularly.
If you have trouble sleeping or suspect you have sleep apnea or another sleep disorder, see a sleep doctor.
If you don’t have a good bedtime routine, make one! (Bedtime Blueprint here) This way, you have a routine to help you relax into bedtime that does not include alcohol.
References:
Brower KJ. Alcohol's effects on sleep in alcoholics. Alcohol Res Health. 2001;25(2):110-25. PMID: 11584550; PMCID: PMC2778757. Fulltext.
Li G, Chen Y, Tang X, Li CR. Alcohol use severity and the neural correlates of the effects of sleep disturbance on sustained visual attention. J Psychiatr Res. 2021 Oct;142:302-311. doi: 10.1016/j.jpsychires.2021.08.018. Epub 2021 Aug 16. PMID: 34416549; PMCID: PMC8429210. Fulltext.
McCullar KS, et al, Altered sleep architecture following consecutive nights of presleep alcohol. Sleep 2024: 47(4):zsae003. https://doi.org/10.1093/sleep/zsae003
Meyrel M, Rolland B, Geoffroy PA. Alterations in circadian rhythms following alcohol use: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry. 2020 Apr 20;99:109831. doi: 10.1016/j.pnpbp.2019.109831. Epub 2019 Dec 3. PMID: 31809833. Fulltext.
Roehrs T, Roth T. Sleep, sleepiness, sleep disorders and alcohol use and abuse. Sleep Med Rev. 2001 Aug;5(4):287-297. doi: 10.1053/smrv.2001.0162. PMID: 12530993. Pubmed.
